[Therapeutic aspects of laparotomy after digestive fistula or after surgical intervention for acute pancreatitis (author's transl)].
Fourteen cases of digestive fistulas, complicated by a dehiscence of the laparotomy wound, are described. Ten patients have a single fistula and 4 have multiple digestive fistulas. There were eleven survivors. This represents a mortality of 21.4%. In 9 cases, the spontaneous recovery of the fistulated zone is followed by a losing of the laparotomy wound. In 2 cases, surgical intervention was necessary to permit the recovery of the fistula and of the dehiscence of the laparotomy. The treatment of such patients requires a mean hospitalization in an intensive care ward of about 48 days +/- 25.8 (SD). The authors report the different therapeutic aspects: the nutritional support, the control of the infection and of the locoregional and systemic complications.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000601:surgery*; D010288:Parenteral Nutrition; D010289:Parenteral Nutrition, Total; D013529:Surgical Wound Dehiscence / Q000150:complications / Q000628:therapy*; D013530:Surgical Wound Infection / Q000628:therapy
Aspects thérapeutiques de la déhiscence d'une plaie de laparotomie après fistule digestive ou après intervention pour pancréatite aiguë.